In a move that will have ramifications for collision sports, the US National Institutes of Health has officially recognized a causal link between repeated blows to the head and the neurodegenerative disease chronic traumatic encephalopathy (CTE).
The NIH is the world’s largest biomedical research agency and the decision to rewrite its official guidelines on CTE has been described by campaign groups as a tipping point in the debate over the risks of participating in collision sports. In the opinion of the NIH, the research to date suggests that the causal link between repeated traumatic brain injury and CTE is clear and unequivocal.
This position is at odds with that held by the Concussion in Sport Group, which is backed by Fifa, World Rugby and the IOC, among others. Concussion consensus documents published by the CISG have consistently downplayed the link between CTE and brain injury sustained in sport. a position that has been used by many sports federations as they defend themselves against legal challenges and calls for reform.
The NIH shift in focus was made after a group of 41 leading scientists, physicians and epidemiologists co-signed a letter to the National Institute of Neurological Disorders and Stroke (Ninds). The letter cited a recent review of CTE research, published in July in the journal Frontiers in Neurology, which established a clear causal link to the types of recurrent brain damage suffered by abuse victims, soldiers and athletes. especially.
This has been proven to be the case since the disease was first recognized in the 1950s, with Ninds’ manager saying the causation was “pretty clear” in 2014, but their official guidelines did not reflect not that so far.
The change aligns the NIH with the US Centers for Disease Control and Prevention, which said in their 2019 advisory: “Most research suggests that CTE is caused in part by exposure to repeated traumatic brain injury. . This means that two of the world’s leading independent medical research organizations agree on the causes of CTE.
It remains to be seen if the next CISG consensus on concussions will reflect this. The group is hosting a conference in Amsterdam on Thursday and Friday to draft the latest version of the consensus, which will be released early next year.
The CISG is already under increased scrutiny after its chairman and lead author, Dr Paul McCrory, resigned this year when it was alleged there were several instances of plagiarism in his own work. At the time McCrory was quoted on Retraction Watch apologizing, saying his failure to attribute was “not deliberate or intentional.”
“Now that causation has been established, the world has a tremendous opportunity to prevent future cases of CTE,” said a spokesperson for the nonprofit Concussion Legacy Foundation. “The only known cause of CTE is environmental exposure and, in most cases, a choice – the choice to engage in contact sports.
“Our aim is to reform all youth sports so that they no longer include avoidable repetitive impacts to the head before the age of 14 – no caps in football, no tackles in [American] football and rugby.
“This change, combined with logical limits on repeated head impacts in sports for people over the age of 14 (such as the ban on hitting in football/rugby practice and strict limits on headers in practice) should prevent the vast majority of future cases of CTE.”